Direct Relief of Levodopa-Induced Dyskinesia by Stimulation in the Area Above the Subthalamic Nucleus in a Patient With Parkinson's Disease —Case Report—

Yasumasa NISHIKAWA; Kazutaka KOBAYASHI; Hideki OSHIMA; Chikashi FUKAYA; Takamitu YAMAMOTO; Yoichi KATAYAMA; Akira OGAWA; Kuniaki OGASAWARA

doi:10.2176/nmc.50.257

Case Reports

Direct Relief of Levodopa-Induced Dyskinesia by Stimulation in the Area Above the Subthalamic Nucleus in a Patient With Parkinson's Disease

—Case Report—

Yasumasa NISHIKAWA, Kazutaka KOBAYASHI, Hideki OSHIMA, Chikashi FUKAYA, Takamitu YAMAMOTO, Yoichi KATAYAMA, Akira OGAWA, Kuniaki OGASAWARA

Author information

Yasumasa NISHIKAWA
Department of Neurosurgery, Iwate Medical University School of Medicine
Kazutaka KOBAYASHI
Division of Applied System Neuroscience, Advanced Medical Research Center, and Department of Neurological Surgery, Nihon University School of Medicine
Hideki OSHIMA
Division of Applied System Neuroscience, Advanced Medical Research Center, and Department of Neurological Surgery, Nihon University School of Medicine
Chikashi FUKAYA
Division of Applied System Neuroscience, Advanced Medical Research Center, and Department of Neurological Surgery, Nihon University School of Medicine
Takamitu YAMAMOTO
Division of Applied System Neuroscience, Advanced Medical Research Center, and Department of Neurological Surgery, Nihon University School of Medicine
Yoichi KATAYAMA
Division of Applied System Neuroscience, Advanced Medical Research Center, and Department of Neurological Surgery, Nihon University School of Medicine
Akira OGAWA
Department of Neurosurgery, Iwate Medical University School of Medicine
Kuniaki OGASAWARA
Department of Neurosurgery, Iwate Medical University School of Medicine

Keywords: deep brain stimulation of subthalamic nucleus, dyskinesia, Parkinson's disease, antidyskinetic effect, area above subthalamic nucleus

JOURNAL OPEN ACCESS

2010 Volume 50 Issue 3 Pages 257-259

DOI https://doi.org/10.2176/nmc.50.257

Details

Abstract

A 71-year-old woman with a 25-year history of levodopa (LD)-responsive Parkinson's disease (PD) developed on-off motor fluctuation and severe peak dose dyskinesia. She underwent deep brain stimulation of the subthalamic nucleus (STN-DBS). STN-DBS induced attenuation of her cardinal PD symptoms and marked improvement of dyskinesia without reduction of LD dosage perioperatively. STN-DBS thus markedly attenuated the cardinal symptoms of PD. LD-induced dyskinesia can also be controlled via reduction of LD dosage as an indirect effect of STN-DBS. The present case provides evidence of the direct antidyskinetic effect of STN-DBS, and suggests that LD-induced dyskinesia can be inhibited by stimulation in the area above the STN.

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